title: Risk factors and management of diabetes in elderly French patients.
abstract: OBJECTIVE
  The aim of this study was to assess the characteristics of elderly diabetic patients, evaluate the relationship between glycaemic control and diabetes complications, and compare the day-to-day management of such patients with the published recommendations.
  
  
  METHODS
  The study included 238 elderly diabetic patients, for whom data for the past six months' medical history, clinical examination (including ocular fundus) and standard biological tests were collected.
  
  
  RESULTS
  The patients' mean age was 82.2+/-7.2, HbA(1c) value was > or =8.5% in 24% of patients and the mean number of cardiovascular risk factors (CVRF) was 4.1+/-0.7 per patient. Dementia or cognitive impairment was present in 68% of patients. Estimated glomerular filtration rate was 30 mL/min or lesser than 16%. Retinopathy was present in 37% of patients, and 64% had a history of infection in the past six months; more than 50% of patients took insulin. The prevalence of retinopathy, cognitive dysfunction and infections were significantly less frequent in patients with HbA(1c) < or =6.5%. There was a positive correlation between the number of CVRF and the number of cardiovascular anomalies (r=0.19, P<0.001). With the exception of HbA(1c), standard paraclinical tests were performed in less than 50% of patients. There was positive agreement between day-to-day HbA(1c) and HbA(1c) target values in 36% of patients.
  
  
  CONCLUSIONS
  Complications and/or associated diseases were more frequent in this cohort of elderly diabetic patients compared with those in studies not based on clinical examinations. Our results highlight the inadequate management, given the frequent discrepancy between day-to-day HbA(1c) and HbA(1c) targets, of such patients.
authors.affiliation: Geriatrics Department, Rouen University Hospital-Charles Nicolle, 1, rue de Germont, 76031 Rouen cedex, France. doucet.jean@chu-rouen.fr
authors.forename: J
authors.initials: J
authors.lastname: Doucet
authors.forename: L
authors.initials: L
authors.lastname: Druesne
authors.forename: C
authors.initials: C
authors.lastname: Capet
authors.forename: E
authors.initials: E
authors.lastname: Gréboval
authors.forename: I
authors.initials: I
authors.lastname: Landrin
authors.forename: P
authors.initials: P
authors.lastname: Moirot
authors.forename: G
authors.initials: G
authors.lastname: Micaud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology; D001158:Arteries / Q000000981:diagnostic imaging; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000235:genetics; D048909:Diabetes Complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008499:Medical Records; D009765:Obesity / Q000453:epidemiology; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology; D012307:Risk Factors; D018608:Ultrasonography, Doppler
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D002784:Cholesterol